The history and development of several strands of modern psychiatry, psychology and clinical neurosciences have been entwined in a thread that stretches back more and a century and a half. These will, no doubt interact in new and unexpected ways to come.

Original patient register from Fulbourn Asylum. Click for larger view.

From 1868, clinical students in Cambridge saw psychiatric cases at Fulbourn Asylum. In 1893, Foster was working on psychological aspects of the special senses but the proposal from James Ward (1843-1925: professor of mental philosophy and logic, 1897-1925) to establish a laboratory in psychophysics was opposed since it was considered ‘irreligious to place the human soul onto a scale of quantities’. Ward brought WHR (William) Rivers (1864-1922) to Cambridge. The University lectureship to which he was appointed in ‘Physiological and Experimental Psychology’ was subsequently replaced by one in the ‘Physiology of the Senses’ and ‘Experimental Psychology’ – held sequentially by Rivers and Charles Myers (1873-1946); John MacCurdy (1886-1947) was then appointed University lecturer in Psychopathology (from 1923-1947), a post that presaged modern clinical academic psychiatry. His responsibilities were in experimental psychology and experimental medicine, the latter of which he ignored since he was not qualified to practice medicine in the United Kingdom. Rivers gained distinction in neurology through his work with Head on nerve regeneration (Brain 1908: 31; 323-450), the physiology of the senses (Foster’s Textbook of Physiology, 6th edition. Part IV), experimental psychology, ethnology working with the Torres Straits Islanders (Medicine, magic and religion, 1924), and shell-shock through his experience in Liverpool and Craiglockart War Hospital, Edinburgh (see the ‘Regeneration Trilogy’by Pat Barker, 1991-1995): ‘The treatment of war neuroses made him a far happier man. Diffidence gave place to confidence, reticence to outspokenness, a somewhat laboured literary style to one remarkable for its ease and charm’. MacCurdy also had an interest in shell-shock and psychoanalysis, making contributions to the study of reactive depression; his work is summarised in three monographs (The psychology of emotion: morbid and normal, 1925; Common principles in psychology and physiology, 1928; and The structure of morale, 1943). MacCurdy left part of his estate for the provision of a library dedicated to books on psychopathology.

Experimental psychology was initially accommodated in a ‘damp, dark and ill-ventilated cottage’ on Mill Lane. Later, a department was established with funds from the Myers family (1913) and assigned to the Faculty of Biological Sciences in 1926. [Sir] Frederic Bartlett (1886-1969) was elected professor of experimental psychology (1931-1951) supplementing MacCurdy’s University Lectureship in Psychopathology and the University Demonstratorship in Experimental Psychology (1931). He was succeeded by the neuropsychologist Oliver Zangwill (1913-1987, from 1952-1982) who promoted concepts on the localization of brain function, especially memory, through studies of patients with traumatic brain injuries, and after whom The Oliver Zangwill Centre for Neuropsychological Rehabilitation, opened by Cambridgeshire Community Services in 1996, is named; and by Nicholas Mackintosh (from 1982-2002) whose work influenced ideas on intelligence and animal learning. Research into mental illness advanced when [Dame] Ellen Pinsent and [Sir] Horace and [Lady] Emma Darwin endowed the Pinsent-Darwin fund and studentship (from 1922) with a benefaction of £5000 to support ‘research into mental defects, diseases or disorders’ in memory of Hume Pinsent, Erasmus Darwin, David Pinsent and Richard Pinsent, scholars or exhibitioners of St John’s and Trinity Colleges (Cambridge) and Balliol College (Oxford). News of David Pinsent’s death from an accident in 1918 received at Salzburg railway station precipitated an hysterical fugue in his close friend Ludwig Witttgenstein (1889-1951), and Tractatus Logico-Philosophicus (1921)is dedicated to Pinsent. An early Pinsent-Darwin scholar was Robert Dick Gillespie (1897-1945, from 1927-1930) whose concept of reactive depression is summarised in Types of depression (1929). The Pinsent-Darwin scholarship continues to be awarded, annually.

Bartlett helped set up the Medical Research Council’s Applied Psychology Unit (now the Cognition and Brain Sciences Unit; MRC CBU) under the directorship of Kenneth Craik (1914-1945), heading the Unit himself after Craik’s early death from an accident. His successor, Norman Mackworth (1917-2005), realising that the Unit had outgrown space within experimental psychology, bought a Victorian house in Chaucer Road and then told the Medical Research Council that the Unit was moving. Mackworth’s work on fatigue and stress in pilots and radar operators was followed by psychological studies of interest to other governmental departments. Donald Broadbent (1926-1993) directed the Unit from 1958 working on information processing (Perception and Communication, 1958); and he was succeeded by Alan Baddeley (from 1974-1995) who maintained the tradition of cognitive psychology but also took the Unit in a more clinically applied direction. William Marslen-Wilson was director until 2010 and continued this direction through his own work on the cognitive and neuroscience of language and the general strategy of the Unit. He was succeeded as director by Susan Gathercole, herself a student of Baddeley.

Paget supervised the first psychiatry clinic at Addenbrooke’s in the late 19th century studying psychological causes of bodily diseases, hypnosis and faith healing as cures, and the relationship between medicine and music. After the Great War, with the increased concern about the nervous sequelae of battle and the influence of psychoanalysis on the study of abnormal mental phenomena, Rivers, Myers and Allbutt proposed a psychological clinic at Addenbrooke’s with two aims “ (i) the treatment of functional nervous disorders and incipient insanity, and (ii) research upon these subjects and the education, especially post-graduate, of students of medicine”. The clinic was supervised, briefly, by Francis Prideaux (1880-1952; from 1920-21, leaving for the Ministry of Pensions), James Lowson (1882- 1954; from 1921-22; a neurologist, psychiatrist and psychoanalyst, former University Demonstrator in Experimental Psychology and, later, professor of Medical Psychology, University of Queensland), Mervyn Archdale (1875-?; in 1921), Philip Cloake (1890-1969; from 1921-1923, who also lectured on social and abnormal psychology and, with expertise in multiple sclerosis, later worked as a neurologist in Birmingham) and Arthur Reardon (from 1923-1925 when he died). Archdale and Reardon were also physician superintendants at Fulbourn Hospital, the Victorian mental asylum, with which increasing links were made. The Addenbrooke’s clinic did not fulfil its aims and, with the death of Rivers and Myers’ departure, the new lectureship in psychopathology was established; as noted above, MacCurdy played no part in clinical work. The arrival of Ralph Noble (1892-1965) as senior consultant psychiatrist at the old Addenbrooke’s Hospital (1934-57), an Australian clinician with roots in the inter-war mental hygiene movement, saw these links wither to the detriment of Fulbourn’s patients who continued to be treated humanely but with outdated therapies. Noble split the psychological clinic into one for nervous, later re-designated psychiatric, diseases and the other for child guidance, both of which he ran. The Ralph Noble prizes for the Cambridge MD are named in his memory and Noble’s portrait in chalk (1951) by Jane de Glehn (1873-1961) hangs in the Clinical School.

Professor Sir Martin Roth

Edward Beresford Davies (1913-2001) was appointed to Fulbourn in the late 1950s. He was a pioneer in the introduction of neuroleptic and anti-depressant medication, and in the involvement of patients in their own care; his “lithium club” grew from a Cambridge base to become a national movement. Davies pressed for the reintegration of psychiatric services with Addenbrooke’s and was subsequently appointed to its consultant staff. With contemporaries including Alan Broadhurst and David Clark, (physician superintendant from 1953-1971; senior psychiatrist from 1971-1983), he achieved the modernisation of psychiatry at Fulbourn during the 1970s, (described in Clark’s book, The story of a mental hospital 1858-1983 [1996]), something that was followed by the de-institutionalisation of the Ida Darwin Hospital for mental handicap, a process completed by a current member of staff, Tony Holland, Professor of the Psychiatry of Learning Disability. Both Broadhurst and Clark facilitated the establishment of today’s clinical academic psychiatry with aims echoing the original Addenbrooke’s clinic.

A Department is born: Sir Martin Roth appointed first Professor of Psychiatry

The University first appointed a professor of psychiatry in 1977. [Sir] Martin Roth (1917-2006: professor of psychiatry 1977-1985) trained both in neurology and psychiatry and came to Cambridge after appointments in Scotland and Newcastle (as professor of psychological medicine, 1959-1977) where he developed old-age psychiatry. Roth worked with Sir Aaron Klug in the MRC Laboratory of Molecular Biology on the neurobiology of Alzheimer’s disease and was influential in re-establishing psychiatry more as a biological than psychoanalytical discipline. He helped the evolution of the Royal Medico-Psychological Association into the Royal College of Psychiatrists and served as its first president (1971-1975).

Emeritus Professor Eugene S. Paykel

Roth’s successor, [Eugene] Gene Paykel (from 1985-2001), pioneered novel psychological therapies for affective disorders and, combining this interest with expertise in psychopharmacology, was professional lead for the national campaign ‘Defeat depression’; an annual lecture in psychiatry bears his name. Ian Goodyer was elected to the foundation chair of child & adolescent psychiatry in 1993 and continues this interest in affective disorder; with the appointment of Ed Bullmore in 1999 (from the Institute of Psychiatry) as a second Professor of Psychiatry, and PB Jones (from the Institute of Psychiatry & Nottingham) in 2000 as successor to Gene Paykel (now emeritus), the professoriate began to grow. This has continued with the establishment of AJ Holland’s Professorship in the Psychiatry of Learning Disability in 2002, and ad hominem promotions for S Baron-Cohen (Developmental Psychopathology; 2002), FA Huppert (Psychology, 2004), BJ Sahakian (Neuropsychology, 2003) and GE Berrios (2007; emeritus in 2009). PC Fletcher was elected to the Bernard Wolf Professorship of Health Neuroscience in 2008; John Suckling to Director of Research (2011) and John O’Brien (2011, Newcastle) to a foundation professorship in old age psychiatry complete the professoriate group that underpins the Department of Psychiatry today.

Current Head of Department, Prof. Peter Jones

Clinical developments in partnership with the NHS include the establishment of modern child & adolescent psychiatry services in the region, the establishment of community services for people with learning disabilities, development of the CLASS clinical for adults with autism and the re-engineering by Bullmore & Jones of the clinical academic unit on ward R4 to become the national award-winning CAMEO service for early intervention in psychosis. Most recently, part of the Department has relocated to the Herchel Smith Building for Brain & Mind Sciences, sharing accommodation with cognate interests in the Department of Experimental Psychology (as the BCNI), the MRC CBU and the Department of Clinical Neurosciences. Establishing a new Cambridge Centre for Affective Disorders (C2AD) with the Cambridgeshire & Peterborough Foundation NHS Trust, the CBU and the BCNI is the most recent embodiment of the interplay and interactions between these organizations and their predecessors over the past century. Most recently, John O’Brien has been appointed from Newcastle as Foundation Professor of Old Age Psychiatry, finally establishing this as a clinical academic discipline in Cambridge following Roth’s original interests and complementing the huge investments into neurodegenerative disease research that he initiated with Klug.

(Adapted and developed from A History of Cambridge Neuroscience (Compston & Jones), 2008).